Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Oregon for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Oregon only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Oregon (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Adam Aufderheide (NPI 1982915344)

Field	Value
Entity Type	Individual
Organization	Adam Aufderheide
Address	748 State St
City	Medford
State	OR
ZIP	97504
Taxonomy	Ophthalmology Physician
NPI Enumerated	June 30, 2010

Payer Source	Total Paid
Medicare	$2.8M
Medicaid	$0

Key Findings

This provider’s billing is effectively single‑payer: lifetime Medicare revenue is $2.8M while there is no Medicaid billing on file, indicating Medicare patients drive the practice’s scale and should be the primary focus for payer/provider analysis and contracting. The absence of Medicaid activity suggests limited participation in state‑program care pathways or a patient mix concentrated in Medicare-eligible populations.

Revenue is highly concentrated in a small set of injectable drug codes: J0178 ($1.6M, 55.9% of Medicare revenue), J2777 ($457.6K, 16.1% of Medicare revenue), and J3490 ($177.4K, 6.2% of Medicare revenue) together account for 78.2% of this provider’s total Medicare revenue. This concentration shows the practice’s economics are dominated by high-value intravitreal therapeutics and related drug billing.

Clinical/service-line mix points to a retina-focused ophthalmology practice: high-volume drug administrations (J0178, J2777, J2781, J2778) and intravitreal injection procedure 67028 (1.6K claims, $147.9K revenue, 5.2%) indicate routine anti-VEGF and other intravitreal therapies as core services. Supporting diagnostics are present too—notably OCT imaging—so the operation combines frequent in-office injections with retinal imaging and follow-up visits rather than being surgery-centric.

Diagnostic imaging volume is an outlier relative to national peers: 92134 has 2.4K claims and $66.8K revenue and ranks #728 of 26868 providers nationally (97th percentile; extreme outlier), while established‑patient intermediate exams 92012 (948 claims, $59.7K) also ranks in the 97th percentile and is described as notably above typical national volume. These datapoints indicate unusually high throughput for retinal imaging and routine ophthalmic follow-up.

Competitive standing on specific drug codes is mixed: J0178 (2.3K claims, $1.6M) ranks #392 of 3204 nationally (88th percentile), signaling a strong national position for aflibercept administration, whereas J2777 (15.8K claims, $457.6K) ranks #674 of 2039 (67th percentile) and J3490 ranks #753 of 2838 (73rd percentile), both consistent with typical national volumes. Additionally, J2781 (1.2K claims, $142.2K) ranks #80 of 490 (83rd percentile), indicating notable utilization of pegcetacoplan relative to the smaller cohort of providers billing that drug.

Surgical retina procedures represent a small share of revenue and volume: vitrectomy/related CPTs such as 67042 (15 claims, $13K) and 67036 (18 claims, $11K) appear infrequently and together account for a minor fraction of Medicare revenue. This suggests the practice focuses on medical retina care and office‑based procedures rather than frequent operating-room surgery.

Provider tenure is long-standing: NPI enumerated 2010-06-30 (~16 years ago), indicating a stable, established billing history in Medicare. That tenure combined with concentrated, repeatable billing for injections and imaging implies an operational model built around recurring treatment regimens and follow-up care rather than episodic care bursts.

For payer strategy and network decisions, the practice’s economics point to drug reimbursement and outpatient injection workflows as key levers: the dominant revenue contribution from injectable drug codes and the lack of Medicaid billing mean negotiations, prior authorization workflows, and supply/infusion logistics tied to Medicare drug reimbursement will have outsized impact on this provider’s revenue and practice operations.

Medicare: Complete Services Breakdown

The CPT/HCPCS codes generating the most Medicare revenue for this provider.

18 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
J0178	Injection, aflibercept, 1 mg	2,310	$690	$1.6M
J2777	Injection, faricimab‑svoa, 0.1 mg	15,780	$30	$457.6K
J3490	Unclassified drugs	100	$1,720	$177.4K
67028	The provider injects a medication into the vitreous chamber of the eye as an isolated procedure or a separate procedure unrelated to any other procedure being performed on the eye.	1,640	$90	$147.9K
J2781	Injection, pegcetacoplan, intravitreal, 1 mg	1,190	$120	$142.2K
J2778	Injection, ranibizumab, 0.1 mg	570	$180	$105K
92134	The provider performs computerized diagnostic imaging of the retina in the posterior segment (back part) of the eye, interprets the data, and provides a report. The service may be on one or both eyes.	2,380	$30	$66.8K
92012	For this CPT code, an Ophthalmologist sees an established patient for an intermediate level eye examination. Generally, a patient is considered to be "established" if the same physician, or any…	950	$60	$59.7K
92014	An ophthalmologist sees an established patient for a comprehensive level eye examination. Generally, a patient is considered to be "established" if the same physician, or any physician in the group…	490	$80	$38.7K
J7999	Compounded drug, not otherwise classified	190	$70	$13.6K

Showing 1–10 of 18

Medicare: Competitive Analysis & Benchmarks

How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 18 CPT/HCPCS codes.

View: State1 / 2

Claims Volume vs. Oregon Distribution

Adam Aufderheide — 2 of 18 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Oregon

Full comparison — all codes billed, vs. state median

18 rows

CPT/HCPCS Code	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
J0178	4	60	840	$680	$623.7K
J2777	10	30	10,050	$30	$527.6K
J2781	3	10	690	$120	$102.6K
J2778	6	20	400	$180	$87.8K
67028	5	70	580	$90	$72.3K
J3490	11	50	40	$640	$42.9K
67036	8	10	30	$1,000	$29K
67042	9	10	20	$1,100	$27.5K
J7999	31	50	270	$70	$23.4K
92014	42	440	110	$80	$16K

Showing 1–10 of 18

Related Providers

Other providers that share a Tax Identification Number (TIN) with Adam Aufderheide, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Retina Care Center, LLC	OR	Ophthalmology Physician	$0	$2.5M
Rocio Diaz Sanjur	SD	Ophthalmology Physician	$623.7K	$0

Nearby Providers

Other providers in the same ZIP code as Adam Aufderheide, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Asante	OR	General Acute Care Hospital	$0	$29.7M
Addictions Recovery Center, Inc.	OR	Substance Abuse Rehabilitation Facility	$0	$29.2M
Asante Physician Partners	OR	Family Medicine Physician	$0	$27.2M
Mercy Flights Incorporated	OR	Ambulance	$3.6M	$19.4M
Providence Health & Services - Oregon	OR	General Acute Care Hospital	$0	$20.9M
Crc Health Oregon, LLC	OR	Methadone Clinic	$193K	$13M
James Kolby Robinson, Dmd	OR	Pediatric Dentistry	$0	$11.6M
Valley Immediate Care, LLC	OR	Urgent Care Clinic/Center	$0	$9.4M
Lincare Inc	OR	Durable Medical Equipment & Medical Supplies	$0	$7.1M
Southern Oregon Pediatrics, LLP	OR	Pediatric Hospice and Palliative Medicine Physician	$0	$6.5M

Adam Aufderheide — Billing Profile & Reimbursement Data

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Adam Aufderheide — Billing Profile & Reimbursement Data

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Key Findings

Medicare: Total Revenue Breakdown by CPT/HCPCS Code

Medicare: Complete Services Breakdown

Medicare: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References